Psych Patient, MD

Straddling the border of sanity

Something to Ponder

Value

To realize The value of a sister
Ask someone Who doesn't have one.

To realize The value of ten years:
Ask a newly Divorced couple.

To realize The value of four years:
Ask a graduate.

To realize The value of one year:
Ask a student who Has failed a final exam.

To realize The value of nine months:
Ask a mother who gave birth to a still born.

To realize The value of one month:
Ask a mother who has given birth to A premature baby.

To realize The value of one week:
Ask an editor of a weekly newspaper.

To realize The value of one hour:
Ask the lovers who are waiting to Meet.

To realize The value of one minute:
Ask a person Who has missed the train, bus or plane.

To realize The value of one-second:
Ask a person Who has survived an accident.

To realize The value of one millisecond:
Ask the person who has won a silver medal in the Olympics

Time waits for no one.

Treasure every moment you have.
You will treasure it even more when
you can share it with someone special.

To realize the value of a friend:
Lose one.

Taken from resource-a-day: Your Internet Resource Page

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Mirrors

You know how there are certain people in your life that just really get on your nerves? You know the ones. The mere mention of their names makes you roll your eyes. Just the thought of them makes your blood boil. Every little thing they say or do absolutely drives you nuts. I once heard that the things that really bug you about other people, are things that you do yourself.

NOOOOOOOOOOOOOOOOOOOOOOOOOOO!

What do you think? Do you hate in others what you hate about yourself?

Support

I used to get so mad when my mom would bug me about dating and getting married. I thought of it as her not-so-subtle way of telling me that I couldn't take care of myself. I thought she was telling me that I would be nothing without a man.

Then she died.

At the funeral, my older sisters had their husbands and children with them. My younger sister and I, both being single, kinda got stuck with each other even though we hadn't spoken to each other in years. That was awkward. During the entire process though, it suddenly hit me what my mother wanted for me. She wanted for me to have someone to depend on for love and support. She wanted me to have a soft place to fall when I couldn't stand on my own. She wanted me to be able to turn around and find someone there ready to hold me and comfort me when I needed it. She wanted me to feel that sense of protection that she tried so hard to provide for me. She didn't want me to feel alone like I did on that day.

My mother was trying to teach me her idea of the natural order of things. Children grow up, get married, and have children of their own. Family perpetuates. She saw me stuck in limbo. She wanted me to move forward to the next milestone. Not because I couldn't make it on my own, but because I shouldn't have to. Life is so much richer when the joys and sorrows are shared with someone you trust to stand by you, to protect you and to love you unconditionally.

During my last moments with my mother before the casket was closed, I whispered to her, "I get it now."

Irritability and Mood Disorders

My medications got to be such a nightmare at one point that I suddenly announced one day to my psychiatrist that I had quit everything cold turkey. My sleep was screwed up, I was constantly nauseated. And I was irritable as hell. Just couldn't take it anymore.

I was sent to another psychiatrist for a consultation about meds. My irritable mood earned me a lithium prescription. Lithium, a poor antidepressant on it own, is often used in conjunction with other antidepressants for treating depression. Lithium is also used as a mood stabilizer for bipolar disorder, or "manic depression." My irritability brought into question my diagnosis. Did I have unipolar or bipolar depression? Maybe I wasn't responding to medication because I wasn't being treated for the correct disorder.

This happened just before I moved to New York, so it must have been during the spring of 2000. I was in treatment for about four years at that point. Did I have a new diagnosis? I never had an obvious manic episode, an extended time period during which I was euphoric, didn't need to sleep at all, felt like I could do anything and got myself into trouble trying to do just that. One manic episode would have given me a bipolar disorder diagnosis right off the bat. But bipolar disorder is divided into Type I and Type II categories. Type I is defined by manic episodes. Type II is defined by "hypomanic" episodes, a kinder, gentler mania you could say. There were times in my life when I did some pretty stupid things, but nothing that would have gotten me into serious trouble. Maybe that's what I had. Then again, maybe my antidepressants just needed a little boost. Only time would tell.

I'm not on lithium anymore, or any other mood stabilizer. Still on the antidepressants. Still don't know what I got.

PS: Two years ago bipolar disorder, type I was officially added to my family psychiatric history.

Quote

Fear not that thy life shall come to an end,
but rather fear that it shall never have a
beginning.

-- John Henry Cardinal Newman

Irritability

Occasionally, a person with clinical depression reports an irritable rather than a depressed mood. The best way I can describe irritability is persistent PMS, because that is what it feels like to me. I have no frustration tolerance. Patience goes right out the window. Nothing in my world goes right. Everybody that crosses my path does so deliberately to annoy me. I go from zero to b*tch in no time flat.

I have been told all my life that I am "hypersensitive." I get ticked off by the stupidest things with no warning. Talking about it doesn't help. No one can calm me down. I just need to be left alone so that I can quiet myself. So often I will just walk off without a word. Some people think that's rude of me. Others call it childish and immature behavior. I have found it to be the only way that I can keep my friends. I know when I am about to say things that I will regret later on. When I was younger, I used to just blurt things out. I never kept friends for very long when I was a kid.

I guess what I want to say is, when someone says to drop the subject, it might be best to do so, at least for the time being. Rational discussions can be held only when both parties are willing and able to do so.

Where Drugs Work

The main targets of antidepressants and other psychoactive medications are brain chemicals called serotonin, dopamine, and norephinephrine. These chemicals are used by brain cells to communicate with each other and regulate most brain functions. These chemicals do not exist only in the brain, though. These chemicals are used by cells throughout the body to regulate all kinds of body functions. So how do drugs know where to act? They don't. Medications will do their thing wherever they find a place to do it. Drugs are easiest to dispense as pills or tablets taken by mouth. When drugs are swallowed, they travel throughout the body before they even get to the brain. Side effects occur from drugs acting where they were not intended to act. Unfortunately, science has not found a way yet to "target" medication such that it will work only where it is supposed to, short of direct administration to the site. I don't think that the world is ready for people to walk around with tubes stuck in their heads for pouring in their antidepressant. I know that I'm not volunteering for the surgery that would be required for that!

Vanity

I pulled six gray hairs from my head last week. That's a depressing thought in and of itself. I'm not even 40 yet. But I'm not worried about getting older. I'm worried about looking older.

Maybe my depression is beginning to lift after all.

Self Image

I cannot accept a compliment gracefully. I attribute anything good in my life to "dumb luck." Everything that I have ever achieved, I did not earn. I just happened to be in the right place at the right time. Yet it is so easy for me to accept and agree with any and all criticism. Even if someone is just teasing me, I am quick to say, "But that's really true!"

Criticism feels more comfortable to me, like that old worn sweatshirt from college with so many bleach stains on it that you can't wear it in public anymore. You know you should be ashamed to wear it, but you can't bring yourself to throw it away.

I don't know why I accept criticism over compliments. Somewhere along the line I internalized some pretty harsh stuff about myself.

People shouldn't live that way. I can tell you personally that it ain't much fun. I make it a point to praise and compliment others whenever I honestly can. Maybe then they will get used to hearing good things about themselves and criticism won't feel as comfortable for them.

Lightbulb

Something Karen said in a comment has helped me immensely.

" ... our depression is so severe that even the death of someone we love does not intensify it, we grieve but the depression is already so intense it is not affected by loss ... "

I have felt horribly guilty for not "grieving" after my mother's death. My own family thinks that I am heartless. When my mother went into the hospital for the last time before her death, I was already in deep trouble with my residency program. But I never told anybody that. Not even the other residents in the program knew how much trouble I was having. Likewise, I never told anyone about my mother being ill. I'm sure that the program thought it was mighty convenient for my mother to suddenly be on her death bed at that particular time. But that's for another entry.

When my mother was admitted to the hospital, everyone in the family called me. They did not know I was having problems, only that I had not been home to visit in seven years. They did not know that as a resident, I did not have the luxury of just picking up and leaving the clinic at a moment's notice. I scheduled my own patients. I was responsible for my patients' charts. I had to find coverage for my clinic patients and my overnight hospital calls. I had to reschedule my supervision time with faculty. I didn't have office staff to do any of that for me. But to them, I was stalling. I just didn't want to come home. Maybe that was true, but it hurt to know what my family really thought of me.

I did make it home to see my mom before she died. I could only stay for a day. I had to get back to the clinic and clean up my charts before taking time off for the funeral. My dad wouldn't let me tell my mom that I had to go back to New York. He didn't want her to know that I was leaving. I never got to say goodbye.

I cried at the funeral home the first time I saw her in the casket. I cried at the wake. I cried at the funeral. It was the only time in my life that my father didn't yell at me for crying.

I haven't cried much since then. I still rarely talk about my mother. Right after her death, I was focussed on my problems with the residency program. I couldn't think about anything else. My professional career was sinking fast and nothing I did was going to stop it.

My therapist has tried several times to get me to talk about my mother, and usually I get angry and shut down. I was afraid to tell him that I didn't feel anything when it came to my mother. I thought that something was wrong with me. I wasn't grieving like I was supposed to be. I didn't miss her like I was supposed to be. I didn't feel any different than I normally did.

Thank you, Karen, for making the comment that you did. It makes sense that if I am already depressed, maybe I can't get any lower than I already am. I think of my mother often, and it is always fondly. Rather than cry, I usually smile when she comes to mind. Maybe I shouldn't think of that as weird.

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